15823

Removal of excessive skin and fat of upper eyelid

Medicare pricing data for 5,177 providers across 52 states

🤖AI Overview

Note: These costs reflect the Medicare physician/supplier component. Hospital facility fees are billed separately and can be 2-5x the physician fee.

💡 What You Should Know

Removal of excessive skin and fat of upper eyelid (HCPCS code 15823) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $683.66, but hospitals typically charge $3,226 — a 4.7x markup. Prices vary significantly by state and provider.

🏷️ Typical Out-of-Pocket Cost

$136.73

Medicare patients typically pay about 20% of the allowed amount as coinsurance. Based on the average allowed cost of $683.66, your out-of-pocket cost would be approximately $136.73. Actual costs depend on your specific plan, deductible, and whether you've met your annual out-of-pocket maximum.

Average Allowed Cost
$683.66
Average Hospital Charge
$3,226
Markup Ratio
4.7x

What Hospitals Charge vs. What Medicare Pays

Hospital Charge$3,226.29
Medicare Allowed$683.66
Medicare Payment$540.18

Hospitals charge 4.7x more than what Medicare allows for this procedure. Medicare actually pays $540.18 on average.

Cost by State

Medicare-allowed amounts vary significantly by state

StateAllowed CostHospital ChargeProvidersServicesvs. National
District of Columbia$867$3,41613112+26.8%
California$817$3,80157110,769+19.5%
Massachusetts$774$2,7581051,717+13.2%
Connecticut$767$4,72261633+12.2%
Alaska$766$6,24220181+12.0%
Oregon$750$2,9981061,380+9.7%
Rhode Island$731$2,717463+6.9%
New York$730$4,0932022,261+6.7%
West Virginia$727$2,35928258+6.4%
Washington$720$2,0751163,216+5.4%
Illinois$711$3,8461401,801+4.0%
Hawaii$709$3,08018295+3.8%
New Jersey$703$4,14192984+2.8%
Vermont$701$2,2115198+2.5%
Nevada$698$3,02329808+2.1%
Wisconsin$696$6,054961,216+1.8%
Virginia$696$2,6021262,027+1.8%
Delaware$694$4,31016812+1.6%
Indiana$694$5,856871,346+1.5%
Kentucky$690$3,27850785+1.0%
Wyoming$688$2,017963+0.6%
Michigan$685$2,6531692,767+0.2%
Maryland$685$2,4691122,067+0.2%
New Hampshire$681$3,66717555-0.4%
Texas$680$4,3633657,284-0.5%
New Mexico$678$2,11715151-0.8%
Colorado$673$3,163922,058-1.6%
North Carolina$672$2,5981374,331-1.7%
Florida$672$2,53348413,542-1.7%
Iowa$670$3,690621,420-2.0%
Arizona$669$2,9681014,369-2.2%
Pennsylvania$664$3,2222423,532-2.8%
Missouri$664$3,0561122,252-2.8%
Nebraska$664$2,578411,217-2.9%
Georgia$663$5,3091393,141-3.0%
South Carolina$662$2,8821092,740-3.1%
Louisiana$656$2,957581,104-4.1%
Montana$651$2,27925654-4.8%
South Dakota$650$2,430301,157-4.9%
Ohio$648$3,4811783,761-5.2%
Oklahoma$643$3,394712,847-5.9%
Maine$640$2,46314417-6.3%
Kansas$633$2,941731,486-7.4%
Idaho$633$2,17050840-7.4%
Alabama$633$2,337861,451-7.5%
Arkansas$631$1,738571,790-7.7%
Tennessee$622$2,6081184,194-9.0%
North Dakota$617$2,88026641-9.7%
Utah$599$3,659511,166-12.4%
Mississippi$592$3,132782,071-13.4%
Minnesota$568$2,9401242,762-16.9%
Puerto Rico$534$78615137-22.0%

⚠️ Important: These costs reflect the Medicare physician/supplier component. Hospital facility fees may be billed separately. Total out-of-pocket costs may be higher.

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